Impact of staffing shortage on patient safety sitters.

ABSTRACT: Patient safety sitters play a crucial role in observing patients at risk for self-harm or harm to others. This article explores the impact of staffing shortages on patient safety sitters, discussing a review of 163 patient safety events. The findings underscore the need for adequate staffing levels and propose solutions, including alternative measures like tele-sitters and increased family involvement, to mitigate the challenges posed by these shortages and improve overall patient safety and care quality.

Seeking Solace in Gambling: The Cycle of Gambling and Intimate Partner Violence Against Women Who Gamble.

This study explored women's gambling in response to male intimate partner violence (IPV). Twenty-four women were recruited through service providers and online advertising. All women had been victimised by IPV and all experienced problems relating to the gambling on electronic gaming machines (EGMs). Thematic analysis of their in-depth interviews identified three major themes. The main pattern of gambling and IPV (Theme 1) was where ongoing coercive control preceded the woman's gambling. Situational violence in response to gambling was also observed. Regardless of temporal sequence, a self-perpetuating cycle of gambling and IPV victimisation was typically apparent, with both issues escalating over time. Reflecting severe traumatic violence, push factors from IPV that motivated the women's gambling (Theme 2) included physical escape, psychological escape, hope of regaining control over their lives, and gambling to cope with the legacy of abuse. Pull factors attracting these women to gambling venues (Theme 3) appeared to have heightened appeal to these victims of IPV. These included venues' social, geographic and temporal accessibility, allowance for uninterrupted play on EGMs, and the addictive nature of EGMs. These push and pull factors led to these women's prolonged and harmful gambling while exacerbating their partner's violence. Concerted efforts are needed to assist women in this cycle of IPV and gambling, prevent violence against women, and reduce harmful gambling products and environments.

Lived Experience Performance to Reduce Stigma, Enhance Understanding of Gambling Harm and Change Attitudes and Behaviours of Professionals and Community Members.

Gamblers and their family members or friends (affected others) can experience stigma and shame due to gambling which can result in a reluctance to seek timely support. However, gamblers and affected others access intersecting health services and talk to friends or family, thereby providing opportunities for early intervention. Three sides of the coin is a group of storytellers with lived experience of gambling harm who use dramatic performance to share personal stories to enhance the understanding of gambling-related harm in allied professions and the broader community. They do this to encourage attitude and behaviour change so that gamblers and affected others receive empathy and support during encounters with these groups. A mixed-methods study was used to explore whether these performances were successful in increasing understanding and changing attitudes and behaviour of allied professionals and the community in the short and longer-term. Data collected immediately post-performance revealed that performances increased understanding of gambling, and improved attitudes and behavioural intent of audience members in relation to gamblers and affected others. Professionals also reported an increased willingness and confidence to discuss gambling harm with clients. Follow-up data demonstrated potential longer-term impact, with respondents continuing to report more positive attitudes towards those affected by gambling harm and professionals being confident to explore gambling issues in their clients and provide appropriate referrals. These finding demonstrate that performance based on lived experience can be a powerful education tool, encouraging deep connection to the issue, resulting in a nuanced understanding and sustained attitudinal and behavioural change.

Exome sequencing identifies variants in FKBP4 that are associated with recurrent fetal loss in humans.

Recurrent pregnancy loss (RPL) is defined as two or more consecutive miscarriages and affects an estimated 1.5% of couples trying to conceive. RPL has been attributed to genetic, endocrine, immune and thrombophilic disorders, but many cases remain unexplained. We investigated a Bangladeshi family where the proband experienced 29 consecutive pregnancy losses with no successful pregnancies from three different marriages. Whole exome sequencing identified rare genetic variants in several candidate genes. These were further investigated in Asian and white European RPL cohorts, and in Bangladeshi controls. FKBP4, encoding the immunophilin FK506-binding protein 4, was identified as a plausible candidate, with three further novel variants identified in Asian patients. None were found in European patients or controls. In silico structural studies predicted damaging effects of the variants in the structure-function properties of the FKBP52 protein. These were located within domains reported to be involved in Hsp90 binding and peptidyl-prolyl cis-trans isomerase (PPIase) activity. Profound effects on PPIase activity were demonstrated in transiently transfected HEK293 cells comparing wild-type and mutant FKBP4 constructs. Mice lacking FKBP4 have been previously reported as infertile through implantation failure. This study therefore strongly implicates FKBP4 as associated with fetal losses in humans, particularly in the Asian population.

Inherited duplications of PPP2R3B predispose to nevi and melanoma via a C21orf91-driven proliferative phenotype.

PURPOSE: Much of the heredity of melanoma remains unexplained. We sought predisposing germline copy-number variants using a rare disease approach. METHODS: Whole-genome copy-number findings in patients with melanoma predisposition syndrome congenital melanocytic nevus were extrapolated to a sporadic melanoma cohort. Functional effects of duplications in PPP2R3B were investigated using immunohistochemistry, transcriptomics, and stable inducible cellular models, themselves characterized using RNAseq, quantitative real-time polymerase chain reaction (qRT-PCR), reverse phase protein arrays, immunoblotting, RNA interference, immunocytochemistry, proliferation, and migration assays. RESULTS: We identify here a previously unreported genetic susceptibility to melanoma and melanocytic nevi, familial duplications of gene PPP2R3B. This encodes PR70, a regulatory unit of critical phosphatase PP2A. Duplications increase expression of PR70 in human nevus, and increased expression in melanoma tissue correlates with survival via a nonimmunological mechanism. PPP2R3B overexpression induces pigment cell switching toward proliferation and away from migration. Importantly, this is independent of the known microphthalmia-associated transcription factor (MITF)-controlled switch, instead driven by C21orf91. Finally, C21orf91 is demonstrated to be downstream of MITF as well as PR70. CONCLUSION: This work confirms the power of a rare disease approach, identifying a previously unreported copy-number change predisposing to melanocytic neoplasia, and discovers C21orf91 as a potentially targetable hub in the control of phenotype switching.

Stereoselective Analysis of Methadone and EDDP in Laboring Women and Neonates in Plasma and Dried Blood Spots and Association with Neonatal Abstinence Syndrome.

OBJECTIVE: This pilot study evaluated the relationship between maternal and neonatal R- and S-methadone and R- and S-2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) exposure and the severity of neonatal abstinence syndrome (NAS). The use of dried blood spots (DBS) as an alternative for plasma in assessing methadone and EDDP was also assessed. STUDY DESIGN: Women receiving methadone for medication assisted treatment of opioid use disorder during pregnancy were eligible for recruitment. Plasma and DBS samples were collected from mothers during labor, from cord blood, and from newborns during genetic screen. R-/S-methadone and EDDP were measured by high-performance liquid chromatography tandem mass spectrometry (HPLC/MS/MS). Associations between methadone exposure, neonatal morphine requirements, and severity of NAS were examined. RESULTS: Twenty women and infants completed the study. Maternal methadone dose at delivery was 112 mg/day (range = 60-180 mg/day). Sixteen neonates experienced NAS requiring morphine; three also required phenobarbital. Higher cord blood concentrations of R-methadone, R- and S-EDDP were associated with higher maximum doses of morphine (p < 0.05). CONCLUSION: Maternal methadone and cord blood concentration at delivery are variable and may be potential markers of neonatal abstinence syndrome.

The likely association between wandering spleen and absent left kidney.

Wandering spleen is a cause of acute surgical abdomen with serious consequences. It arises from an absence or weakness of the supporting suspensory splenic ligaments. There is often a delayed diagnosis due to its non-specific clinical presentation. This leads to stalled acquisition of confirmatory diagnostic imaging with resultant increased morbidity and mortality. Congenital or acquired absence of the left kidney results in loss of the splenorenal ligament, a key ligament to maintain normal splenic position in the abdomen. Two patients, one with OHVIRA (obstructed hemivagina ipsilateral renal anomaly) syndrome and another who underwent a left nephrectomy during infancy, developed a wandering spleen with acute splenic torsion in the setting of an absent left kidney. This case series aims to increase awareness to the likely predisposition for individuals with an absent left kidney to develop a wandering spleen.

A Systematic Review and Activation Likelihood Estimation Meta-Analysis of fMRI Studies on Sweet Taste in Humans.

BACKGROUND: The reward value of palatable foods is often cited as an important influence on eating behaviors, including intake of sugars. However, human neuroimaging studies have generated conflicting evidence on the basic neural representation of taste and reward responses to caloric sweeteners (sucrose and glucose), and most relevant studies have used small subject numbers. OBJECTIVE: We conducted a systematic review and a coordinate-based meta-analysis of studies reporting brain responses to oral sugar solutions. METHODS: A systematic search of MEDLINE, Scopus, and PsycINFO through October 2019 identified fMRI studies (in healthy human adults, including those with overweight or obesity) assessing differences in responses to purified sweet and nonsweet taste stimuli. Data were extracted with the primary objective of quantifying evidence for the activation of brain regions associated with caloric sweet taste sensation. We used activation likelihood estimation meta-analysis methods. We also performed multiple sensitivity analyses to assess the generality of effects. RESULTS: Of 455 unique articles, 15 met the criteria for inclusion. These contributed to 2 primary meta-analyses: 1) sucrose (13 experiments, 179 coordinates, n = 241) and 2) sucrose + glucose (16 experiments, 209 coordinates, n = 262). Consistent activation was apparent in primary taste areas: insula (69.2% of studies) and opercular cortex (76.9% of studies), precentral gyri (53.9% of studies), and globus pallidus and postcentral gyrus (30.8% of studies for each). Evidence of reward activity (caudate) was seen in the primary analyses (30.8% of studies) but not in sensitivity analysis. CONCLUSIONS: We confirm the importance of primary taste areas for gustatory processing in human adults. We also provide tentative evidence for reward-related caudate activity in relation to the sweet taste of caloric sugars. A number of factors affect the observation and interpretation of brain responses, including reward-related activity. Firm conclusions require confirmation with large data set studies.

A Behavioral and Electrophysiological Investigation of Effects of Visual Congruence on Olfactory Sensitivity During Habituation to Prolonged Odors.

Congruent visual cues augment sensitivity to brief olfactory presentations and habituation of odor perception is modulated by central-cognitive processing including context. However, it is not known whether habituation to odors could interact with cross-modal congruent stimuli. The present research investigated the effect of visual congruence on odor detection sensitivity during continuous odor exposures. We utilized a multimethod approach, including subjective behavioral responses and reaction times (RTs; study 1) and electroencephalography (EEG, study 2). Study 1: 25 participants received 2-min presentations of moderate-intensity floral odor delivered via olfactometer with congruent (flower) and incongruent (object) image presentations. Participants indicated odor perception after each image. Detection sensitivity and RTs were analyzed in epochs covering the period of habituation. Study 2: 25 new participants underwent EEG recordings during 145-s blocks of odor presentations with congruent or incongruent images. Participants passively observed images and intermittently rated the perceived intensity of odor. Event-related potential analysis was utilized to evaluate brain processing related to odor-visual pairs across the period of habituation. Odor detection sensitivity and RTs were improved by congruent visual cues. Results highlighted a diminishing influence of visual congruence on odor detection sensitivity as habituation occurred. Event-related potential analysis revealed an effect of congruency on electrophysiological processing in the N400 component. This was only evident in early periods of odor exposure when perception was strong. For the first time, this demonstrates the modulation of central processing of odor-visual pairs by habituation. Frontal negativity (N400) responses encode the aspects of cross-modal congruence for odor-vision cross-modal tasks.

Thermal Decomposition and Hypergolic Reaction of a Dicyanoborohydride Ionic Liquid.

In this study, in situ infrared spectroscopy techniques and thermogravimetric analysis coupled with mass spectrometry (TGA-MS) are employed to characterize the reactivity of the ionic liquid, 1-butyl-3-methylimidazolium dicyanoborohydride (BMIM+DCBH-), in comparison to the well-characterized 1-butyl-3-methylimidazolium dicyanamide (BMIM+DCA-) ionic liquid. TGA measurements determined the enthalpy of vaporization (ΔHvap) to be 112.7 ± 12.3 kJ/mol at 298 K. A rapid scan Fourier transform infrared spectrometer was used to obtain vibrational information useful in tracking the appearance and disappearance of species in the hypergolic reactions of BMIM+DCBH- and BMIM+DCA- with white fuming nitric acid (WFNA) and in the thermal decomposition of these energetic ionic liquids. Attenuated total reflectance measurements recorded the infrared spectra of the reactant sample (BMIM+DCBH-) and the liquid reaction products after reacting with WFNA. Computational chemistry efforts, aided by the experimental results, were used to propose key reaction pathways leading to the hypergolic ignition of BMIM+DCBH- + WFNA. Experimental results indicate that the hypergolic reaction of BMIM+DCBH- with WFNA generates both common and unique intermediates as compared to previous BMIM+DCA- + WFNA investigations: nitrous oxide was generated during both hypergolic reactions indicating that it may play a crucial role in the hypergolic ignition process, NO2 was generated in significantly higher concentrations for BMIM+DCBH- than for BMIM+DCA-, CO2 was only generated for BMIM+DCA-, and HCN was only generated during thermal decomposition and hypergolic ignition of BMIM+DCBH-.

Canal of Nuck Abnormalities.

Canal of Nuck abnormalities are underrecognized causes of labial masses with potential adverse outcomes. The 2 main categories of canal of Nuck abnormalities are hernias and hydroceles. There are 3 types of canal of Nuck hydroceles: communicating, encysted, and bilocular. Canal of Nuck hernia contents vary, but those containing ovaries need urgent medical attention because of an increased risk of ischemia. Ultrasound can establish a definite diagnosis in all cases. This article reviews the embryologic characteristics, anatomy, pathologic characteristics, and imaging features of these abnormalities while providing a clear pictorial depiction of various unique hernias and hydroceles seen with this entity.

Ignition Delay Reduction with Sodium Addition to Imidazolium-Based Dicyanamide Ionic Liquid.

A range of ionic liquids (ILs) have been synthesized and modeled to better understand the role of the cation in the ignition of hypergolic ionic liquids. Vogelhuber et al. have shown by density functional theory methods that the addition of sodium cations to an ionic liquid promotes ignition with white fuming nitric acid (WFNA) by lowering energy barriers. To validate this prediction, solid sodium dicyanamide (Na+DCA-) was added at various weight percents to 1-butyl-3-methylimidazolium dicyanamide (BMIM+DCA-). The ignition delay was measured for each mixture with WFNA. Overall, it was found that the Na+DCA- lowered the ignition delay by 11 ms at 7 wt %. The calculations done by Vogelhuber et al. appear to be consistent with this observation. The sodium cation may play a role by orienting the anion with the WFNA resulting in the favorable reaction energetics observed.

The Beliefs in Trichotillomania Scale (BiTS): Factor analyses and preliminary validation.

OBJECTIVES: The role of cognitions and beliefs in trichotillomania (TTM; hair pulling disorder) has been the subject of only limited investigation. This study aimed to develop and validate the Beliefs in TTM Scale (BiTS). METHODS: A pool of 50 items based upon themes identified in previous research was administered online to 841 participants with and without self-reported problematic, non-cosmetic hair pulling behaviours. RESULTS: Exploratory and confirmatory factor analyses conducted in randomly split-halves of the sample supported retention of 14 items comprising three factors: negative self-beliefs, low coping efficacy, and perfectionism. CONCLUSIONS: The BiTS demonstrated satisfactory psychometric properties and all three subscales significantly correlated with greater hair pulling severity. Negative self-beliefs predicted hair pulling severity over and above mood symptoms, suggesting the importance of addressing self-construals in psychological treatments for TTM. Validation in a clinician diagnosed sample is required. PRACTITIONER POINTS: Research supports cognitive therapies for treating trichotillomania (hair pulling disorder), although studies investigating the nature and role of cognitions and beliefs in this disorder have been lacking. This study developed and validated a self-report measure of three styles of beliefs most relevant to trichotillomania: negative self-beliefs, low coping efficacy, and perfectionism. Negative self-beliefs predicted the severity of trichotillomania symptoms over and above depression and anxiety, suggesting such cognitions may not necessarily be due to comorbidities. Future research should validate the new measure in a clinician diagnosed sample, and therapies for trichotillomania may be enhanced by targeting shame specifically.

Wagering Advertisements and Inducements: Exposure and Perceived Influence on Betting Behaviour.

A proliferation of wagering advertising has raised concerns about its effects, especially on vulnerable gamblers. This study examined exposure to wagering advertisements and inducements, and their reported influence on the size, frequency and riskiness of bets placed-amongst regular bettors and by gambler risk group. An Ecological Momentary Assessment design minimised recall bias. After completing a baseline survey, 722 regular bettors completed up to 15 surveys administered on 5 days per week over three non-consecutive weeks. Data were analysed for the 316 race bettors and 279 sports bettors completing at least one survey. The results indicate that regular bettors have almost daily exposure to wagering advertising, including for inducements. The most frequently seen and influential advertisement types were direct messages (emails, texts and/or phone calls from wagering operators, which, in Australia, bettors are automatically opted-into when opening a betting account) and advertisements on betting websites or apps. Participants reported the most influential inducements to be: stake-back offers, multi-bet offers, match your stake or deposit offers, better odds/winnings inducements, happy hours, rewards programs, and cash out early offers. The findings indicate that wagering advertisements, including for inducements, are likely to be having powerful effects on regular bettors. On each day that respondents saw these advertisements (most days for most advertisement types), substantial minorities reported increased size and frequency of betting. Results did not vary by gambler risk group. Understanding which types of wagering advertising are associated with most gambling-related harm can inform advertising regulations, targeted public health interventions, and future research.

Where's the Bonus in Bonus Bets? Assessing Sports Bettors' Comprehension of their True Cost.

Wagering inducements with bonus bets are prominently marketed and often have play-through conditions requiring further expenditure. However, these conditions are not usually presented in the inducement advertisement and may be difficult to locate. The play-through conditions themselves are complex and may lead bettors to miscalculate the inducement's true cost. Therefore, in relation to inducements with bonus bets, this study aimed to assess: (1) whether their perceived attractiveness varies with the amount and type of information provided about their play-through conditions; (2) bettors' comprehension of their true cost; and (3) whether bettors' comprehension of their true cost varies with problem gambling severity. A sample of 299 Australian sports bettors completed an online survey and rated the attractiveness of three variations of an inducement. Promo1 simply noted that "terms and conditions apply"; promo2 included the terms and conditions immediately below the offer; and promo3 revealed the true cost of the offer. Respondents were asked to calculate the true cost before this was revealed. The study found that detailing key terms and conditions for an offer directly below the advertisement impacts negatively on its perceived attractiveness. Moreover, nearly three in five bettors underestimated the additional amount they would need to bet to access any winnings from the bonus bet. No significant differences were found amongst gambler risk groups. The results imply that current approaches to marketing these inducements are likely to lead consumers to overestimate their attractiveness and underestimate their cost. To enhance responsible gambling practice, these promotional offers should be presented in ways that enable informed decision-making.

Program of Integrated Care for Patients with Chronic Obstructive Pulmonary Disease and Multiple Comorbidities (PIC COPD+): a randomised controlled trial.

We sought to evaluate the effectiveness of a multi-component, case manager-led exacerbation prevention/management model for reducing emergency department visits. Secondary outcomes included hospitalisation, mortality, health-related quality of life, chronic obstructive pulmonary disease (COPD) severity, COPD self-efficacy, anxiety and depression.Two-centre randomised controlled trial recruiting patients with ≥2 prognostically important COPD-associated comorbidities. We compared our multi-component intervention including individualised care/action plans and telephone consults (12-weekly then 9-monthly) with usual care (both groups). We used zero-inflated Poisson models to examine emergency department visits and hospitalisation; Cox proportional hazard model for mortality.We randomised 470 participants (236 intervention, 234 control). There were no differences in number of emergency department visits or hospital admissions between groups. We detected difference in emergency department visit risk, for those that visited the emergency department, favouring the intervention (RR 0.74, 95% CI 0.63-0.86). Similarly, risk of hospital admission was lower in the intervention group for those requiring hospital admission (RR 0.69, 95% CI 0.54-0.88). Fewer intervention patients died (21 versus 36) (HR 0.56, 95% CI 0.32-0.95). No differences were detected in other secondary outcomes.Our multi-component, case manager-led exacerbation prevention/management model resulted in no difference in emergency department visits, hospital admissions and other secondary outcomes. Estimated risk of death (intervention) was nearly half that of the control.

A discovery and development roadmap for new endectocidal transmission-blocking agents in malaria.

Reaching the overall goal of eliminating malaria requires halting disease transmission. One approach to blocking transmission is to prevent passage of the parasite to a mosquito, by preventing formation or transmission of gametocytes. An alternative approach, pioneered in the veterinary field, is to use endectocides, which are molecules that render vertebrate blood meals toxic for the mosquito vector, also killing the parasite. Field studies and modelling suggest that reducing the lifespan of the mosquito may significantly reduce transmission, given the lengthy maturation process of the parasite. To guide the development of new endectocides, or the reformulation of existing molecules, it is important to construct a framework of the required attributes, commonly called the target candidate profile. Here, using a combination of insights from current endectocides, mathematical models of the malaria transmission dynamics, and known impacts of vector control, a target candidate profile (TCP-6) and a regulatory strategy are proposed for a transmission reducing agent. The parameters chosen can be used to assess the potential of a new medicine, independent of whether it has classical endectocide activity, reduces the insect and parasite lifespan or any combination of all three, thereby constituting an 'endectocidal transmission blocking' paradigm.

Injectable anti-malarials revisited: discovery and development of new agents to protect against malaria.

Over the last 15 years, the majority of malaria drug discovery and development efforts have focused on new molecules and regimens to treat patients with uncomplicated or severe disease. In addition, a number of new molecular scaffolds have been discovered which block the replication of the parasite in the liver, offering the possibility of new tools for oral prophylaxis or chemoprotection, potentially with once-weekly dosing. However, an intervention which requires less frequent administration than this would be a key tool for the control and elimination of malaria. Recent progress in HIV drug discovery has shown that small molecules can be formulated for injections as native molecules or pro-drugs which provide protection for at least 2 months. Advances in antibody engineering offer an alternative approach whereby a single injection could potentially provide protection for several months. Building on earlier profiles for uncomplicated and severe malaria, a target product profile is proposed here for an injectable medicine providing long-term protection from this disease. As with all of such profiles, factors such as efficacy, cost, safety and tolerability are key, but with the changing disease landscape in Africa, new clinical and regulatory approaches are required to develop prophylactic/chemoprotective medicines. An overall framework for these approaches is suggested here.

Comparing Fourth Generation Statistical Iterative Reconstruction Technique to Standard Filtered Back Projection in Pediatric Head Computed Tomography Examinations.

OBJECTIVE: Although advanced statistical iterative reconstruction (IR) techniques are valued in pediatric computed tomography (CT) imaging, there is little published data on how these techniques affect image quality and radiation dose in the pediatric population. This is particularly true in the context of pediatric head CT examinations. This study analyzed the differences in image quality and several standard metrics of radiation dose on multidetector pediatric head CT examinations performed using standard filtered back projection (FBP) with reconstructions using iDose, a fourth-generation statistical iterative reconstruction technique. MATERIALS AND METHODS: Using a retrospective review of 282 pediatric head CT examinations, we compared how iDose fared against FBP for effects on several standard metrics of radiation dose and qualitative and quantitative assessment of image quality. RESULTS: Our assessment revealed that examinations obtained using low-dose protocols reconstructed using iDose, when compared with standard-dose examinations reconstructed using FBP, resulted in significant radiation dose reduction while performing equally or better in quantitative image quality parameters. For most qualitative image quality parameters, the iDose group demonstrated equal performance to standard filtered back technique with a few notable exceptions. In the parameter of image sharpness in the 1.5 to 7 year olds, iDose fared better than FBP. However, FBP outperformed iDose in the qualitative parameters of decreased image graininess/noise in patients older than 13 years, improved image sharpness in patients aged between 7 and 13 years, and improved visibility of small parts for those aged 7 to 13 years. CONCLUSIONS: We conclude that iDose is effective at allowing significant radiation dose reduction while maintaining or, rarely, even improving quantitative image quality compared with FBP in the setting of pediatric head CT examinations. However, for certain qualitative image quality parameters in older-aged children, the use of iDose resulted in a poorer performance compared with FBP.

Pre- and postprandial variation in implicit attention to food images reflects appetite and sensory-specific satiety.

Implicit attentional processes are biased toward food-related stimuli, with the extent of that bias reflecting relative motivation to eat. These interactions have typically been investigated by comparisons between fasted and sated individuals. In this study, temporal changes in implicit attention to food were assessed in relation to natural, spontaneous changes in appetite occurring before and after an anticipated midday meal. Non-fasted adults performed an emotional blink of attention (EBA) task at intervals, before and after consuming preferred, pre-selected sandwiches to satiety. Participants were required to detect targets within a rapid visual stream, presented after task-irrelevant food (preferred or non-preferred sandwiches, or desserts) or non-food distractor images. All categories of food distractor preferentially captured attention even when appetite levels were low, but became more distracting as appetite increased preprandially, reducing task accuracy maximally as hunger peaked before lunch. Postprandially, attentional capture was markedly reduced for images of the specific sandwich type consumed and, to a lesser extent, for images of other sandwich types that had not been eaten. Attentional capture by images of desserts was unaffected by satiation. These findings support an important role of selective visual attention in the guidance of motivated behaviour. Naturalistic, meal-related changes in appetite are accompanied by changes in implicit attention to visual food stimuli that are easily detected using the EBA paradigm. Preprandial enhancement of attention capture by food cues likely reflects increases in the incentive motivational value of all food stimuli, perhaps providing an implicit index of wanting. Postprandial EBA responses confirm that satiation on a particular food results in relative inattention to that food, supporting an important attentional component in the operation of sensory-specific satiety.